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A former Pittsburgh Steelers lineman who died three years ago after leading police on a high-speed chase had signs of a brain condition causing dementia and depression found in three other ex-NFL players, The New York Times reported Friday.

Justin Strzelczyk was killed when he collided with a tractor-trailer on the New York State Thruway in upstate New York after leading police on a 40-mile high-speed chase. Before his death he said he was hearing voices from "the evil ones" and suffering from depression.

Dr. Bennet Omalu, a neuropathologist at the University of Pittsburgh Medical Center, told the Times a recent study of Strzelczyk's brain tissue showed he had chronic traumatic encephalopathy, or CTE, a finding two other doctors confirmed. Omalu believes the conditon was caused by multiple trauma sustained on the football field.

The condition, which can only be diagnosed in dead patients or by an invasive biopsy, is characterized by tangles of nerve fibers in the brain's cortex. The symptoms can include memory loss, depression and dementia similar to Alzheimer's disease and is typically found in elderly people in their 80s and in boxers suffering from dementia.

"This is extremely abnormal in a 36-year-old," Dr. Ronald Hamilton of the University of Pittsburgh, who confirmed Omalu's findings, told the Times. "If I didn't know anything about this case and I looked at the slides, I would have asked, 'Was this patient a boxer?'"

According to Omalu, an autopsy of Andre Waters, who shot himself to death last November at age 44, showed his brain tissue resembled that of an 85-year-old man and shared characteristics of early stage Alzheimer's. Omalu said he found similar conditions in the brains of former Steelers Mike Webster, a Hall-of-Fame center who suffered from dementia before his death from heart failure in 2002, and Terry Long, who committed suicide by drinking antifreeze last June.

Also, former New England Patriots linebacker Ted Johnson has said he suffers from depression and memory loss after enduring multiple concussions as a player.

According to the Times, NFL spokesman Greg Aiello said that the league had no comment on Omalu's findings in the Strzelczyk case, while NFLPA executive director Gene Upshaw did not respond to telephone messages seeking comment.

Strzelczyk, a 6-foot-6, 300-pound offensive lineman with the Steelers between 1990 and 1998, was experiencing an apparent breakdown the morning of Sept. 30, 2004, when he led police on a 40-mile chase down the New York State Thruway in his pickup truck after being involved in a minor traffic mishap near Syracuse.

According to media accounts of the incident, he drove 15 miles on three tires and a rim after one of his tires was punctured by metal spikes thrown onto the road to stop him and was "flipping off" troopers, throwing a beer bottle at one. The incident ended near Herkimer, when Strzelczyk swerved into the westbound lanes of the Thruway to avoid a truck that had pulled across the highway to stop him and collided head-on into a tanker truck.

Earlier this year, Dr. Julian Bailes, the chairman of the department of neurosurgery at West Virginia University and the Steelers' team neurosurgeon during Strzelczyk's career, suggested to Omalu that Strzelczyk's brain tissue might have been preserved from his autopsy, the Times reported. Bailes, is also the medical director of the Center for the Study of Retired Athletes at the University of North Carolina and has co-authored several papers citing links between concussions and later emotional and cognitive problems.

Mary Strzelczyk, the late player's mother, granted Omalu permission to study the brain tissue for signs of CTE, saying she wanted to better understand what led her son to his death. On Wednesday, as she looked at images of her son's brain damage on a computer screen, she told the Times they would be "a piece of the puzzle."

"I'm interested for me and for other mothers," she told the Times. "If some good can come of this, that's it. Maybe some young football player out there will see this and be saved the trouble."

Omalu told the newspaper he is confident the damage was caused by concussions Strzelczyk might not have reported, because players did not know the symptoms of a concussion or would not report them for fear of appearing weak.

"Could there be another cause? Not to my knowledge," Bailes told the Times. He also said that bipolar disorder, which Strzelczyk appeared to be exhibiting in the months before his death, would not have been caused by CTE but could have been made worse by it.

Omalu and Bailes told the newspaper the diagnosis stands out because the condition manifested itself when Strzelczyk was in his mid-30s. Long and Waters were in their 40s when they committed suicide, while Webster was 50 and had suffered from numerous physical ailments and chronic pain in addition to dementia.

So where does this leave football... trading in the pads for flags??? All the stories are sad, and probably has a lot to do with the contact and hits sustained while playing the game, but there is a warning label on the helmet. Science and technology is getting better though and players now-a-days are taking the necessary precautions for concussions and what not. Hopefully, they can get a handle on this matter before those who like to protest everything start up with the NFL wanting the pads traded in for flags!

So where does this leave football... trading in the pads for flags??? All the stories are sad, and probably has a lot to do with the contact and hits sustained while playing the game, but there is a warning label on the helmet. Science and technology is getting better though and players now-a-days are taking the necessary precautions for concussions and what not. Hopefully, they can get a handle on this matter before those who like to protest everything start up with the NFL wanting the pads traded in for flags!

Well, I see 3 ways to improve the safety for the players.

1. Flag Football rules (not going to happen)
2. Improve helmets (good option but probably has its limits)
3. Pull the plug on player careers after they reach a certain brain injury threshold - much like a boxing commission won't let really messed up boxers fight.

Option 2 is an obvious one. Option 3 would be difficult to implement as medical technology has a hard time objectivley showing damage from most consussions. If they started limiting carreers due to head injury, you'd get more guys trying to hide it.

But I think society is becoming much more aware of issues related to traumatic brain injury as a result of the Iraq war. I bet that awareness spills over to have an effect on the NFL in the next decade.

They are already working on the helmets and have some in place that is suppose to help with preventing concussions. I know off hand Charlie Batch and I believe Manning wears this type of helmet, but I'm not exactly sure how much they actually help? You're right there is only so much that can be done with the helmet.

Pulling the plug on players careers would lead to the players hiding their injuries and possibly causing more damage and maybe even leading to a death on the field which is the last thing the NFL would need...

As long as people are willing to do extremely dangerous activities as a career (their livelihood for years and years), there's not much you can do. How many people are good at multiple sports and choose the one that's less dangerous? There really isn't much that can be done. They've been changing the rules to protect people, which is good, but sooner or later you'll change the rules so much that no one wants to watch.

Lineman, Dead at 36, Exposes Brain Injuries

By ALAN SCHWARZ
WEST SENECA, N.Y., June 13 — Mary Strzelczyk spoke to the computer screen as clearly as it was speaking to her. “Oh, Justin,” she said through sobs, “I’m so sorry.”
The images on the screen were of magnified brain tissue from her son, the former Pittsburgh Steelers offensive lineman Justin Strzelczyk, who was killed in a fiery automobile crash three years ago at age 36. Four red splotches specked an otherwise tranquil sea — early signs of brain damage that experts said was most likely caused by the persistent head trauma of life in football’s trenches.

Strzelczyk (pronounced STRELL-zick) is the fourth former National Football League player to have been found post-mortem to have had a condition similar to that generally found only in boxers with dementia or people in their 80s. The diagnosis was made by Dr. Bennet Omalu, a neuropathologist at the University of Pittsburgh Medical Center. In the past five years, he has found similar damage in the brains of the former N.F.L. players Mike Webster, Terry Long and Andre Waters. The finding will add to the growing evidence that longtime football players, particularly linemen, might endure hidden brain trauma that is only now becoming recognized.

“This is irreversible brain damage,” Omalu said. “It’s most likely caused by concussions sustained on the football field.”

Dr. Ronald Hamilton of the University of Pittsburgh and Dr. Kenneth Fallon of West Virginia University confirmed Omalu’s findings of chronic traumatic encephalopathy, a condition evidenced by neurofibrillary tangles in the brain’s cortex, which can cause memory loss, depression and eventually Alzheimer’s disease-like dementia. “This is extremely abnormal in a 36-year-old,” Hamilton said. “If I didn’t know anything about this case and I looked at the slides, I would have asked, ‘Was this patient a boxer?’ ”

The discovery of a fourth player with chronic traumatic encephalopathy will most likely be discussed when N.F.L. officials and medical personnel meet in Chicago on Tuesday for an unprecedented conference regarding concussion management. The league and its players association have consistently played down findings on individual players like Strzelczyk as anecdotal, and widespread survey research of retired players with depression and early Alzheimer’s disease as of insufficient scientific rigor.

The N.F.L. spokesman Greg Aiello said that the league had no comment on the Strzelczyk findings. Gene Upshaw, executive director of the N.F.L. Players Association, did not respond to telephone messages seeking comment.

Strzelczyk, 6 feet 6 inches and 300 pounds, was a monstrous presence on the Steelers’ offensive line from 1990-98. He was known for his friendly, banjo-playing spirit and gluttony for combat. He spiraled downward after retirement, however, enduring a divorce and dabbling with steroid-like substances, and soon before his death complained of depression and hearing voices from what he called “the evil ones.” He was experiencing an apparent breakdown the morning of Sept. 30, 2004, when, during a 40-mile high-speed police chase in central New York, his pickup truck collided with a tractor-trailer and exploded, killing him instantly.

Largely forgotten, Strzelczyk’s case was recalled earlier this year by Dr. Julian Bailes, the chairman of the department of neurosurgery at West Virginia University and the Steelers’ team neurosurgeon during Strzelczyk’s career. (Bailes is also the medical director of the University of North Carolina’s Center for the Study of Retired Athletes and has co-authored several prominent papers identifying links between concussions and later-life emotional and cognitive problems.) Bailes suggested to Omalu that Strzelczyk’s brain tissue might be preserved at the local coroner’s office, a hunch that proved correct.

Mary Strzelczyk granted permission to Omalu and his unlikely colleague, the former professional wrestler Christopher Nowinski, to examine her son’s brain for signs of chronic traumatic encephalopathy. Nowinski, a former Harvard football player who retired from wrestling because of repeated concussions in both sports, has become a prominent figure in the field after spearheading the discovery earlier this year of C.T.E. inside the brain of Andre Waters, the former Philadelphia Eagles defensive back who committed suicide last November at age 44.

Tests for C.T.E., which cannot be performed on a living person other than through an intrusive tissue biopsy, confirmed the condition in Strzelczyk two weeks ago. Omalu and Nowinski visited Mary Strzelczyk’s home near Buffalo on Wednesday to discuss the family’s psychological history as well as any experiences Justin might have had with head trauma in and out of sports. Mary Strzelczyk did not recall her son’s having any concussions in high school, college or the N.F.L., and published Steelers injury reports indicated none as well.

Omalu remained confident that the damage was caused by concussions Strzelczyk might not have reported because — like many players of that era — he did not know what a concussion was or did not want to appear weak. Omalu also said that it could have developed from what he called “subconcussive impacts,” more routine blows to the head that linemen repeatedly endure.

“Could there be another cause? Not to my knowledge,” said Bailes, adding that Strzelczyk’s car crash could not have caused the C.T.E. tangles. Bailes also said that bipolar disorder, signs of which Strzelczyk appeared to be increasingly exhibiting in the months before his death, would not be caused, but perhaps could be exacerbated, by the encephalopathy.

Omalu and Bailes said Strzelczyk’s diagnosis is particularly notable because the condition manifested itself when he was in his mid-30s. The other players were 44 to 50 — several decades younger than what would be considered normal for their conditions — when they died: Long and Waters by suicide and Webster of a heart attack amid significant psychological problems.

Two months ago, Omalu examined the brain tissue of one other deceased player, the former Denver Broncos running back Damien Nash, who died in February at 24 after collapsing following a charity basketball game. (A Broncos spokesman said that the cause of death has yet to be identified.) Omalu said he was not surprised that Nash showed no evidence of C.T.E. because the condition could almost certainly not develop in someone that young. “This is a progressive disease,” he said.

Omalu and Nowinski said they were investigating several other cases of N.F.L. players who have recently died. They said some requests to examine players’ brain tissue have been either denied by families or made impossible because samples were destroyed.
Bailes, Nowinski and Omalu said that they were forming an organization, the Sports Legacy Institute, to help formalize the process of approaching families and conducting research. Nowinski said the nonprofit program, which will be housed at a university to be determined and will examine the overall safety of sports, would have an immediate emphasis on exploring brain trauma through cases like Strzelczyk’s. Published research has suggested that genetics can play a role in the effects of concussion on different people.

“We want to get a idea of risks of concussions and how widespread chronic traumatic encephalopathy is in former football players,” Nowinski said. “We are confident there are more cases out there in more sports.”

Mary Strzelczyk said she agreed to Omalu’s and Nowinski’s requests because she wanted to better understand the conditions under which her son died. Looking at the C.T.E. tangles on a computer screen on Wednesday, she said they would be “a piece of the puzzle” she is eager to complete for herself and perhaps others.
“I’m interested for me and for other mothers,” she said. “If some good can come of this, that’s it. Maybe some young football player out there will see this and be saved the trouble.”